Objective: We aimed to determine the frequency, type, and mortality rate of central nervous system infections (CNSI) in patients infected with the human immune deficiency virus (HIV). Methods: A total of 353 HIV/AIDS cases hospitalized in our clinic between January 2014 and March 2020 were retrospectively analyzed. Patients diagnosed with CNSI were included in the study. Epidemiological data, diagnoses, clinical, and laboratory information, and clinical progress data of the cases were collected from patient files and recorded. Variables were analyzed. Results: Thirty-four (9.6%) of 353 inpatients diagnosed with HIV/AIDS were followed with CNSI diagnosis. 88.2% of the cases were male, and the median age was 43.5 [interquartile range (IQR)= 26-62) ]. Toxoplasma encephalitis (n=7, 20.6% ), neurosyphilis (n=7, 20.6%), tuberculous meningitis (n=4, 11.8%), cryptococcal meningitis (n=4, 11.8%), HIV encephalopathy (n =3, 8.8%), progressive multifocal leukoencephalopathy (PML) (n=3, 8.8%), and bacterial meningitis (n=2, 5.9%), and 1 case of herpes simplex virus (HSV) encephalitis, varicella zoster virus (VZV) encephalitis, chronic encephalitis, cytomegalovirus (CMV) meningoencephalitis were seen. The median CD4+ T lymphocyte count of the cases was 44.5 /uL (IQR=5-627), HIV RNA level was 215 000 copies/mL (IQR=20-617 000) in patients under antiretroviral therapy (ART), 227 500 (IQR=32 000-4 500 000) copies/ml in patients not receiving ART. CD4+ T lymphocyte count of 25 (73.4%) patients was <200/uL. Twenty-one patients (61.8% ) were simultaneously diagnosed with HIV/AIDS and CNSI, and 14 were in the AIDS stage. The mortality rate was 32.4 % (n=11), and all fatal cases had CD4+ T lymphocyte counts below 200/uL. Conclusion: Central nervous system infections continue to cause severe mortality and morbidity in HIV-infected individuals. We observed that the frequency and mortality rate of CNSI is higher in patients who do not know their HIV status, late-presenters, and those who are not under treatment and/or do not adhere to treatment. Facilitating access to diagnostic tests, rapid treatment initiation, and counseling on treatment compliance is essential to prevent CNSI and, thus, reduce mortality.
Background: Human immunodeficiency virus (HIV) is still a challenge for children. About 15 to 45% of the HIV positive pregnant women can transmit the virus to their children during pregnancy, delivery and/or breastfeeding. The risk of transmission can be decreased my several measures. Aims: To identify factors associated with HIV infection in children born to HIV-infected mothers. Study Design: A multi-center retrospective cohort study. Methods: A ten-year retrospective cohort study in five dedicated HIV centers was conducted. The 325 women in our cohort were between the ages of 18 and 45. During the study period, 44 (13.5%) of these women gave birth and 51 babies were born. Of the 51 infants, 7 (13.7%) were HIV/AIDS positive. Results: Among the factors studied, breastfeeding, having a HIV-positive sibling and being on antiretroviral treatment during pregnancy and detectable HIV-RNA during delivery were found statistically significant. A multivariable logistic regression analysis showed that being on antiretroviral treatment during pregnancy is the most important predictor of mother-to-child transmission. Conclusion: Mother-to-child transmission appears to be an important route of HIV transmission in Turkey. Lack of antiretroviral treatment during pregnancy appears to be a key factor in transmission.
Objective: It has been reported that approximately 90% of patients who are infected with human immunodeficiency virus (HIV) have various cutaneous symptoms that are related to the virus. This study aims to describe the cutaneous disorders that have developed in HIV-infected patients and to investigate the factors that may be related, such as relationships to drug use and CD4 counts. Methods: This cross-sectional study included people who were living with HIV and being followed by our hospital’s infectious diseases clinic after they had been referred to the dermatology clinic because of skin lesions. These patients had been diagnosed with HIV by enzyme-linked immunosorbent assay tests and were included in the study if they were older than 18 years and had agreed to participate. Findings from detailed dermatological examinations were recorded, along with the patients’ CD4 counts, the durations of their illnesses, and the treatments they received. Results: 144 patients were included in the study. The most common mucocutaneous manifestation was seborrheic dermatitis, at 28.5% (n = 41). The mean CD4 count was 607.1 (min-max = 10.6-1982).The CD4 counts were divided into three groups in the study as follows: 22 (15.3%) patients with <200, 35 (24.3%) patients between 200 and 500, and 87 (60.4%) patients with >500. There were no statistical differences between these groups in terms of dermatological findings. Nevertheless, the highest rate of patients with three or more dermatological conditions was found among those with CD4 counts <200 (n = 11.50%). Conclusion: Skin manifestations are common in patients who are HIV-positive; however, many skin disorders can be seen in HIV/acquired immunodeficiency syndrome (AIDS) patients whatever CD4 cell counts of these patients are.
Objective: In the determination and monitoring of neurocognitive disorders in human immunodeficiency virus (HIV)-positive individuals, there is a need for significantly more practical methods which provide results in a shorter time than the tests that require challenging and specialized expertise. This study aimed to evaluate cognitive functions and the factors affecting them in naïve HIV-positive patients using by Montreal Cognitive Assessment (MoCA) test before and after the initiation of combination antiretroviral therapy.Materials and Methods: HIV-positive, treatment-naïve patients monitored between January-June 2017 were included in the study. The MoCA test was performed at the beginning and the sixth month of the treatment.Results: Forty male patients were included in the study. The mean age was calculated as 29.1±4.0. When the factors affecting the MoCA score were examined, there was a significant relationship between the education level and the MoCA score. Smoking, using alcohol, and substance did not have a significant impact on baseline MoCA values. A significant correlation was found between cluster differentiation 4 (CD4) count and HIV RNA level and attention function. There was a significant increase in the total MoCA score and the MoCA subgroup scores at the end of the sixth month of the treatment. Conclusion:MoCA test is one of the most practical tests that can be applied in a short time period, and it was found useful in evaluating the changes in the cognitive functions of HIVpositive patients during antiretroviral treatment.
Yeni tanı alan, "human immunodeficiency virus" (HIV) ile infekte bireylere, mortalite ve morbiditenin azaltılması ve diğer kişilere bulaşın engellemesi için hızlı antiretroviral tedaviye (ART) başlanması önerilmektedir. Hastanın tedaviyi alma ve tedavi altında kalma olasılığını artırdığı, viral baskılanmayı sağlamak için gereken süreyi azalttığı ve viral baskılanma oranlarını artırdığı için tedaviye mümkün olduğu kadar erken başlanması gerektiği vurgulanmaktadır. Ancak sağlık kuruluşunun altyapısı, hastanın klinik-sosyal durumu ve başlanacak tedavinin niteliği hızlı ART'ye uygun olmalıdır.
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